ASSOCIATION BETWEEN PINEAL NEOPLASM AND ALZHEIMER’S DISEASE PROGRESSION IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT: A POPULATION-BASED COHORT STUDY
Author(s)
Jimin Do, MS1, Miryoung Kim, PhD2, Hae Sun Suh, MA, MS, PhD3;
1Kyung Hee University, Department of Regulatory Science, Graduate School, Seoul, Korea, Republic of, 2Sunchon National University, College of Pharmacy, Suncheon, Korea, Republic of, 3Kyung Hee University, College of Pharmacy, Seoul, Korea, Republic of
1Kyung Hee University, Department of Regulatory Science, Graduate School, Seoul, Korea, Republic of, 2Sunchon National University, College of Pharmacy, Suncheon, Korea, Republic of, 3Kyung Hee University, College of Pharmacy, Seoul, Korea, Republic of
OBJECTIVES: This study evaluated the association between pineal neoplasm and the risk of progression to AD among patients with mild cognitive impairment (MCI) using nationwide claims data.
METHODS: A population-based retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment claims data (January 2019-November 2022). Patients diagnosed with MCI (ICD-10: F06.7) were categorized into an exposure group with pineal neoplasm (ICD-10: D35.4, C75.3, D44.5) and a non-exposure group. A two-step matching process was implemented: (1) the non-exposure group was assigned an index date corresponding to the pineal neoplasm diagnosis date of the exposure group via exact matching on age, sex, and insurance type at MCI diagnosis. Patients with a history of AD (ICD-10: F00, G30) prior to the assigned index date were excluded; (2) 1:3 propensity score (PS) matching was performed without replacement. Clinical characteristics, including the Charlson Comorbidity Index, mental disorders, were captured from claims history prior to the index date. Covariate balance was assessed using the standardized mean difference (SMD). The primary outcome was incident AD. Patients were followed until AD diagnosis, death, or study end, whichever came first. Hazard ratios (HRs) were estimated using Cox proportional hazards models adjusting for residual imbalance (SMD>0.1), and restricted mean survival time (RMST) differences were estimated.
RESULTS: Before PS matching, we identified 302 exposed and 820,798 unexposed patients. After matching, 295 patients in the exposure group and 885 patients in the non-exposure group were included. The adjusted HR for AD (exposure vs non-exposure) was 1.38 (95% CI 0.93-2.03). The RMST difference was -15.76 days (95% CI -72.92-46.74).
CONCLUSIONS: In this nationwide cohort study, pineal neoplasm was not significantly associated with incident AD among patients with MCI. Future studies should incorporate subtype-specific analyses, ensure sufficient follow-up, and include external validation.
METHODS: A population-based retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment claims data (January 2019-November 2022). Patients diagnosed with MCI (ICD-10: F06.7) were categorized into an exposure group with pineal neoplasm (ICD-10: D35.4, C75.3, D44.5) and a non-exposure group. A two-step matching process was implemented: (1) the non-exposure group was assigned an index date corresponding to the pineal neoplasm diagnosis date of the exposure group via exact matching on age, sex, and insurance type at MCI diagnosis. Patients with a history of AD (ICD-10: F00, G30) prior to the assigned index date were excluded; (2) 1:3 propensity score (PS) matching was performed without replacement. Clinical characteristics, including the Charlson Comorbidity Index, mental disorders, were captured from claims history prior to the index date. Covariate balance was assessed using the standardized mean difference (SMD). The primary outcome was incident AD. Patients were followed until AD diagnosis, death, or study end, whichever came first. Hazard ratios (HRs) were estimated using Cox proportional hazards models adjusting for residual imbalance (SMD>0.1), and restricted mean survival time (RMST) differences were estimated.
RESULTS: Before PS matching, we identified 302 exposed and 820,798 unexposed patients. After matching, 295 patients in the exposure group and 885 patients in the non-exposure group were included. The adjusted HR for AD (exposure vs non-exposure) was 1.38 (95% CI 0.93-2.03). The RMST difference was -15.76 days (95% CI -72.92-46.74).
CONCLUSIONS: In this nationwide cohort study, pineal neoplasm was not significantly associated with incident AD among patients with MCI. Future studies should incorporate subtype-specific analyses, ensure sufficient follow-up, and include external validation.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH107
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding, Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Geriatrics, SDC: Neurological Disorders, SDC: Oncology